Eyeworld

30 | EYEWORLD | FALL 2024 ATARACT C Reference 1. Fram NR, et al. Clinical outcomes of the small aperture IOL for complex corneas with irregular astigmatism. Paper presented at the 2024 ASCRS Annual Meeting, April 5–8, 2024, Boston, Massachusetts. HOAs of what the vision will potentially be, and it's a good way to see if this would be the right technology for your patients. "If it's too dim, then you know it's not the right technolo- gy, and monofocal with scleral lens is the best approach," she said. corrected vision, or we can do a monofocal lens and a scleral lens fitting.' That was all we had to offer them, and many didn't want to wear contacts." Dr. Fram and colleagues presented a paper on clinical outcomes in patients with irregular corneas receiving small aperture technology at the 2024 ASCRS Annual Meeting. 1 The patients studied included those who had RK, keratoco- nus, post-PKP, and corneal scarring outside the visual axis. Fifty complex cornea eyes were examined, and Dr. Fram said the results were impressive with patients achieving 7.2 lines of improve- ment in uncorrected distance visual acuity and 2.4 lines of improvement in uncorrected near. However, all patients were counseled that they might need scleral contact lenses even after the IC-8 Apthera technology, she said. Dr. Fram said a caveat with these patients is you need to ensure that there is no central scarring when you use the IC-8 Apthera technol- ogy. A preoperative pinhole test in the office or a pilocarpine 1% test is helpful to make sure that the dimming is acceptable to the patient. The iTrace technology (Tracey Technolo- gies) can simulate a small aperture, she added. That gives you a simulation when you remove continued from page 29 continued on page 33 In "Clinical outcomes of the small aperture IOL for complex corneas with irregular astigmatism," presented at the 2024 ASCRS Annual Meeting, UCDVA improved by 7.2 lines and UCNVA improved by 2.4 lines at 3 months. Source: Nicole Fram, MD "I say, 'One eye gets better far vision, while in the second eye with the IC-8 Apthera, we will sacrifice some sharpness and brightness to gain intermediate and some near vision.' If they are OK with this, we proceed." —Robert Ang, MD

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